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[目的]探讨鼻咽癌放疗后颈淋巴结复发的影像学特征及临床意义。[方法]分析2002～2008年在本院确诊为鼻咽癌放疗后颈淋巴结复发38例的影像学表现。[结果]颈淋巴结复发以Ⅱ区最常见,约74%(28/38),多区复发约63%(24/38)。86%(25/29)为原部位复发。复发淋巴结以形态不规则且边缘不清楚及包膜外侵犯多见,在MRI-STIR序列上病变以中等及低信号多见。DWI以高低不等的混杂信号多见,实性区的平均ADC值为0.79×10-3mm2/s,坏死区为2.08×10-3mm2/s。[结论]鼻咽癌放疗后颈淋巴结复发MRI表现不典型。结合MRI弥散加权成像(DWI)、PET/CT等多种影像检查技术有助于早期诊断。
[Objective] To investigate the imaging features and clinical significance of cervical lymph node recurrence after radiotherapy of nasopharyngeal carcinoma. [Methods] The imaging findings of 38 cases of cervical lymph node recurrence after nasopharyngeal carcinoma radiotherapy in our hospital from 2002 to 2008 were analyzed. [Results] The recurrence of cervical lymph node was the most common in the region Ⅱ, about 74% (28/38), and the multi-region recurrence was about 63% (24/38). 86% (25/29) of the original site of recurrence. Recurrence of lymph nodes to irregular shape and unclear margins and extracapsular invasion more common in the MRI-STIR sequence lesions with more common and low signal. DWI is more common in mixed signals with different heights. The average ADC value of real area is 0.79 × 10-3mm2 / s, and the necrotic area is 2.08 × 10-3mm2 / s. [Conclusion] MRI findings of cervical lymph node recurrence after radiotherapy of nasopharyngeal carcinoma are not typical. Combined with MRI diffusion-weighted imaging (DWI), PET / CT and other imaging techniques to help early diagnosis.